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Int J Emerg Med 2022 May 17;15(1):19. Epub 2022 May 17.

Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.

Background: A well-known anesthetic, lidocaine is the most widely used local anesthetic. Local anesthetic systemic toxicity (LAST) is a life-threatening event with common and prominent presentations of central nervous system (CNS) toxicity and cardiovascular toxicity. The most frequent and prominent early warning signs and symptoms of LAST are central nervous system symptoms. Read More

Cureus 2022 Mar 19;14(3):e23310. Epub 2022 Mar 19.

Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, USA.

As a renowned local anesthetic agent of choice, lidocaine is also a class 1b antiarrhythmic agent that is primarily used for the treatment of ventricular arrhythmias. Although lidocaine systemic toxicity is rare, it may be life-threatening; thus, its early identification and management are of vital importance. This case report details the clinical scenario of intravenous lidocaine administration to a patient at high risk of toxicity in a 64-year-old patient, who initially presented with sustained monomorphic ventricular tachycardia received lidocaine and subsequently developed neurologic manifestations of lidocaine toxicity, including altered mental status and seizure. Read More

Pharmaceutics 2022 Mar 26;14(4). Epub 2022 Mar 26.

Laboratoire de Pharmacologie Clinique, Service de Pharmacologie Clinique, APHM, INSERM, Institut Neurosciences Système, UMR 1106, Aix Marseille Université, 13005 Marseille, France.

Background: Local anesthetic systemic toxicity (LAST) has been reported as a serious complication of local anesthetic (LA) peripheral injection. The signs and symptoms of LAST are highly variable, and the challenge remains to confirm its diagnosis. In this context, the determination of LA plasma concentration appears as a valuable tool to confirm LAST diagnosis. Read More

Gland Surg 2022 Mar;11(3):599-610

Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Background: Breast cancer has become the most common malignancy worldwide. Experimental and, retrospective, clinical data indicate that anaesthetic technique might influence the risk of metastasis after cancer surgery by modulating the immune system. The purpose of this study is to investigate the effect of perioperative lidocaine injection on immune cells such as T lymphocytes and natural killer cells (NK cells) and the quality of postoperative recovery in breast cancer patients and to propose new ideas and relevant theoretical evidence for the selection of anesthetic protocols for perioperative tumor patients. Read More

Minerva Anestesiol 2022 Apr 5. Epub 2022 Apr 5.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand -

Background: Laparoscopic cholecystectomy (LC) has become the gold standard for gallbladder removal due to the low degree of invasiveness. However, postoperative pain still persists. Local anesthetics provide analgesia, reduce opioid consumption, and accelerate the return of bowel activity with a rare incidence of toxicity. Read More

J Anaesthesiol Clin Pharmacol 2021 Oct-Dec;37(4):610-615. Epub 2021 Dec 15.

Department of Anesthesiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Background And Aims: Forearm Modified Bier Block (FMBB) reduces local anesthetic systemic toxicity risks compared to the traditional method. This study was designed and implemented to compare the effects of lidocaine-dexmedetomidine (LD) and lidocaine-saline (LS) on the characteristics of the MFBB in distal forearm and hand surgery.

Material And Methods: In this randomized double-blind trial, which was conducted after obtaining institutional ethical committee approval, 60 patients were enrolled and randomly divided into two groups. Read More

A A Pract 2022 Mar 23;16(3):e01576. Epub 2022 Mar 23.

From the Department of Anesthesiology, University of Kansas School of Medicine - Wichita, Wichita, Kansas.

Headache after subarachnoid hemorrhage and corresponding craniotomy with aneurysm clipping can be severe and difficult to treat. Currently accepted analgesic therapies are often ineffective at treating the pain without incurring unacceptable side effects. We present an innovative approach wherein intravenous lidocaine infusions were used to successfully treat 2 patients with hyperalgesia refractory to traditional analgesic therapies. Read More

Cureus 2022 Feb 13;14(2):e22175. Epub 2022 Feb 13.

Psychiatry, Mercy General Hospital, Sacramento, USA.

A cataract is the primary cause of preventable blindness and is characterized by a congenital, developmental, or acquired opacity of the human lens. Cataracts are predominantly treated through surgical procedures utilizing a combination of anesthetic agents such as proparacaine to reduce patient discomfort. Proparacaine is used to inhibit voltage-gated sodium channels on neuronal membranes to prevent signal propagation and pain signaling in the patient. Read More

Environ Sci Technol 2022 02 7;56(4):2312-2322. Epub 2022 Feb 7.

State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.

The residues of pharmaceuticals in surface waters of megacities and ecotoxicological implications are of particular concern. In this study, we combined field investigations and model simulations to explore the contamination of cardiovascular and lipid-lowering drugs, one group of the most prescribed medications globally, in surface waters of a typical megacity, Shanghai, with a high wastewater treatment ratio (≈96%). Among 26 target substances, 19 drugs were detected with aqueous concentrations ranging from 0. Read More

J Cosmet Dermatol 2022 Apr 21;21(4):1445-1447. Epub 2022 Feb 21.

The Layt Clinic, Southport, Qld, Australia.

Background: Limited dilute lidocaine infiltration facilitates a comfortable procedure and a rapid recovery process following a novel intervention for reduction of cellulite. Infiltration of dilute lidocaine has many other practical applications in dermatologic surgery.

Objectives: This article describes a safe, effective technique for local infiltration of limited volume dilute lidocaine anesthesia in a cellulite reduction procedure. Read More

Anesth Pain Med (Seoul) 2022 Apr 28;17(2):228-234. Epub 2021 Dec 28.

Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.

Background: Local anesthetics systemic toxicity (LAST) is a grave complication of regional anesthesia that usually occurs immediately after local anesthetics injection. Here, we report on rare late-onset toxicity cases after supraclavicular brachial plexus blocks.

Case: Two patients underwent surgery for radius fractures. Read More

Transpl Immunol 2022 04 29;71:101510. Epub 2021 Nov 29.

Anesthesiology Department, The Forth people's hospital of Jinan, China.

Background: Lidocaine was an anesthetic commonly used for analgesia, but the neurotoxicity could not be ignored. However, benzodiazepines could alleviate the toxicity when combined with other drugs.

Purpose: To explore the molecular mechanism of benzodiazepines in protecting nerve cells after the induction of lidocaine. Read More

Oxid Med Cell Longev 2021 12;2021:3827501. Epub 2021 Nov 12.

Center for Clinical Research and Translational Medicine, The Affiliated Lianyungang Oriental Hospital of Xuzhou Medical University, Lianyungang 222042, China.

Acute lung injury (ALI) is one of the fatal symptoms of sepsis. However, there were no effective clinical treatments. TF accumulation-induced fibrin deposit formations and coagulation abnormalities in pulmonary vessels contribute to the lethality of ALI. Read More

Pak J Pharm Sci 2021 Sep;34(5):1699-1705

Department of Anesthesiology, Hunan Cancer Hospital, Changsha, Hunan, P.R. China.

Acute respiratory distress syndrome (ARDS) or acute lung injury (ALI) is associated with decreased aquaporin-5 (AQP5) expression. Lipopolysaccharides (LPS) can decrease AQP5 expression. The effects and mechanisms of lidocaine pretreatment on primary alveolar epithelium type II (AEC II) cells injured by LPS were investigated. Read More

Curr Opin Obstet Gynecol 2021 12;33(6):440-444

Complex Family Planning, Obstetrics and Gynecology Department, Stanford University, Palo Alto, California, USA.

Purpose Of Review: To review the current literature focusing on pain management and experiences during abortion care.

Recent Findings: Analgesic options in abortion care address pain associated with the procedure, osmotic dilator insertion, and cervical preparation. The paracervical block (PCB) is effective for pain control in first and second trimester abortions. Read More

Am J Emerg Med 2022 Apr 25;54:325.e3-325.e6. Epub 2021 Oct 25.

Section of Medical Toxicology, Department of Emergency Medicine, St. Luke's University Health Network, Bethlehem, PA, USA. Electronic address:

Lidocaine and prilocaine are local anesthetics, a class of medications which are frequently used in clinical medicine to minimize pain in a variety of procedures. They are commonly found in over-the-counter products such as topical anesthetic creams advertised to relieve localized muscle and joint pain. While safe and well-tolerated when used appropriately, an overdose of these anesthetics increases the risk for local anesthetic systemic toxicity (LAST), which in severe cases can present with seizures, cardiac dysrhythmias, and ultimately cardiovascular collapse. Read More

Clin Case Rep 2021 Oct 10;9(10):e04910. Epub 2021 Oct 10.

Department of Internal Medicine Hue University of Medicine and Pharmacy Hue University Hue City Vietnam.

The systemic toxicity of lidocaine is an extremely rare complication of thyroid RFA procedure, and it can be life-threatening. The quick recognization of its symptoms and intravenous use of lipid emulsion are essential to preventing mortality. Read More

Biomed Pharmacother 2021 Dec 12;144:112309. Epub 2021 Oct 12.

Faculty of Medicine, Tabriz University of Medical Sciences, Iran; Student Research Committee, Tabriz University of Medical Sciences, Iran.

Anesthetics are extensively used during cancer surgeries. The progression of cancer can be influenced by perioperative events such as exposure to general or local anesthesia. However, whether they inhibit cancer or act as a causative factor for metastasis and exert deleterious effects on cancer growth differs based on the type of cancer and the therapy administration. Read More

Dermatol Pract Concept 2021 Sep 1;11(4):e2021120. Epub 2021 Sep 1.

Division of Dermatology, Cook County Health, Chicago, IL, USA.

Front Pharmacol 2021 16;12:678437. Epub 2021 Sep 16.

Translational Neuroscience Centre, West China Hospital, Sichuan University, Chengdu, China.

lidocaine is one of the most commonly used local anesthetics for the treatment of pain and arrhythmia. However, it could cause systemic toxicities when plasma concentration is raised. To reduce lidocaine's toxicity, we designed a hydroxyl derivative of lidocaine (lido-OH), and its local anesthesia effects and systemic toxicity were quantitively investigated. Read More

J Wound Care 2021 Sep;30(Sup9a):IIi-IIv

Department of Biostatics, Selçuk University, Konya, Turkey.

Objective: Local anaesthetics are often used in plastic surgery practice. Through their mechanism of action, local anaesthetics produce a sympathetic blockage with a subsequent vasodilatation and a resulting local increase of perfusion. The effect of vasodilation of the local anaesthetics causes bleeding locally resulting in haematoma, bruising and/or pain. Read More

J Anal Toxicol 2021 Sep 30. Epub 2021 Sep 30.

NMS Labs, 200 Welsh Road, Horsham, PA 19044.

Toxic adulterants are drug or chemical agents used to add bulk volume to traditional drugs of abuse such as cocaine, and heroin. These cutting agents include levamisole, metamizole, noxiptillin, phenacetin, and xylazine as well as common legal drugs such as acetaminophen, caffeine, diphenhydramine, lidocaine, quinine, quetiapine, and tramadol. Because they possess pharmacological activity they result in exposure of the user, but also in the case of pregnant women, the developing fetus, to potential drug toxicity. Read More

J Int Med Res 2021 Sep;49(9):3000605211047770

Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.

Shoulder manipulation under ultrasound (US)-guided C5 and C6 nerve root block is effective for treating refractory adhesive capsulitis (AC). We herein report the development of cervical nerve root injury following manipulation under anesthesia (MUA) in a patient with AC. A 47-year-old woman underwent shoulder manipulation under US-guided C5 and C6 root block with 2% lidocaine for the management of AC-induced shoulder pain. Read More

Reg Anesth Pain Med 2021 12 17;46(12):1103-1106. Epub 2021 Sep 17.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.

Background: Multiple myeloma is a cancer of plasma cells that often leads to complications including osteolytic bone lesions, nephropathy and neuropathy. Multiple myeloma is only one etiology of many cancer pain conditions that may necessitate interventional pain treatment when refractory to multimodal medications. Notably, local anesthetic systemic toxicity is a rare but life-threatening complication of local anesthetic administered for these interventions. Read More

Plants (Basel) 2021 Jul 28;10(8). Epub 2021 Jul 28.

Faculty of Environment and Resource Studies, Mahasarakham University, Maha Sarakham 44150, Thailand.

The six species, , , (), (), and were analyzed for phytochemicals, toxicity in PBMCs, and biological activity in two cancer cell lines by MTT and comet assays, and pesticide efficiency. Via GC-MS, lidocaine was found to be the predominant compound in two of the studied species. To confirm the systematics, lidocaine was also found in lower amounts in 11 species. Read More

J Pharm Bioallied Sci 2021 Jun 5;13(Suppl 1):S741-S747. Epub 2021 Jun 5.

General Dentist, Dubai, United Arab Emirates.

Background: Every dentist should anticipate being confronted with a medical emergency (ME), and one should always be ready to treat the most catastrophic ones.

Aim: This study aimed to assess the knowledge of dental clinical students of Tamil Nadu in the ME understanding and management to create awareness toward patient care.

Methodology: A total of 768 dental students, including final-year students and residents from different colleges, took part in the questionnaire-based cross-sectional study. Read More

Am J Emerg Med 2022 02 8;52:267.e5-267.e7. Epub 2021 Aug 8.

Department of Emergency Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, United States of America. Electronic address:

Background: Flecainide is a commonly used IC antiarrhythmic. Clinical presentations of Flecainide toxicity are not commonly described.

Case Report: A 62 year old man on dialysis presented for evaluation of outpatient bradycardia and hypotension. Read More

Vet Med Sci 2021 11 13;7(6):2135-2143. Epub 2021 Aug 13.

Faculty of Veterinary Medicine, Department of Clinical Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran.

The present study was designed to compare the effects of lidocaine and ropivacaine in intravenous regional anaesthesia (IVRA) in dogs. Twelve adult male dogs were used. Under isoflurane anaesthesia, exsanguination was performed in the target forelimb. Read More

Clin Otolaryngol 2022 03 15;47(2):279-286. Epub 2021 Dec 15.

Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester, UK.

Objectives: A dose of 5 mg/kg lidocaine is considered appropriate for paediatric airway topicalisation. Existing literature suggests that younger children are susceptible to toxic lidocaine plasma levels and achieve this at a faster rate.

Main Outcome Measures: The primary outcome of this study was to ascertain peak plasma lidocaine levels after topicalisation for airway endoscopy. Read More